| NPI | 1295001907 |
|---|---|
| Former Name | ELLEN THERESE KLOCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036137516) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036137516) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2021-04-30 |